II 

112TH CONGRESS 

1ST SESSION S. 481 

To enhance and further research into the prevention and treatment of eating 

disorders, to improve access to treatment of eating disorders, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 3, 2011 

Mr. HARKIN (for himself, Ms. KLOBUCHAR, and Mr. FRANKEN) introduced 

the following bill; which was read twice and referred to the Committee 

on Health, Education, Labor, and Pensions 

A BILL 

To enhance and further research into the prevention and 

treatment of eating disorders, to improve access to treatment of eating disorders, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Federal Response to 

5 Eliminate Eating Disorders Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds as follows: 

8 (1) Estimates, based on current research, indi9 cate that at least 5,000,000 people in the United 


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1 States suffer from eating disorders including ano2 rexia nervosa, bulimia nervosa, binge eating dis3 order, and eating disorders not otherwise specified 

4 (referred to in this Act as ‘‘EDNOS’’). 

5 (2) Anecdotal evidence suggests that as many 

6 as 11,000,000 people in the United States, including 

7 1,000,000 males, may suffer from eating disorders. 

8 (3) Eating disorders occur in all nations and in 

9 all populations, and among people of all ages and 

10 races and of both genders. 

11 (4) Eating disorders are diseases with grave 

12 health consequences and high rates of mortality. 

13 (5) Health consequences associated with eating 

14 disorders include heart failure and other serious car15 diac conditions, electrolyte imbalance, kidney failure, 

16 osteoporosis, debilitating tooth decay, and gastro17 intestinal disorders, including esophageal inflamma18 tion and rupture, gastric rupture, peptic ulcers, and 

19 pancreatitis. 

20 (6) Anorexia nervosa has one of the highest 

21 overall mortality rates of any mental illness. Accord22 ing to the National Institute of Mental Health, 1 in 

23 10 people with anorexia nervosa will die of starva24 tion, cardiac arrest, or another medical complication. 


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1 (7) The risk of death among adolescents with 

2 anorexia nervosa is 11 times greater than in disease3 free adolescents. 

4 (8) Anorexia nervosa has the highest suicide 

5 rate of all mental illnesses. 

6 (9) New research suggests that bulimia nervosa 

7 has a much higher rate of mortality than is reflected 

8 in current statistics, because of the failure to iden9 tify the underlying eating disorder. 

10 (10) Binge eating disorder is the most common 

11 eating disorder, with an estimated 3.5 percent of 

12 American women and 2 percent of American men 

13 expected to suffer from this disorder in their life14 time. Binge eating disorder is characterized by fre15 quent episodes of uncontrolled overeating and is as16 sociated with obesity, heart disease, gall bladder dis17 ease, and diabetes. 

18 (11) Research demonstrates that there is a sig19 nificant genetic component to the development of 

20 eating disorders. 

21 (12) Certain populations, including adolescent 

22 females and athletes of both genders, are at higher 

23 risk of developing an eating disorder. 

24 (13) Different types of eating disorders may af25 fect certain races and genders disproportionately. 


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1 (14) Despite the serious health consequences 

2 and the high risk of death, Federal research funding 

3 for eating disorders has lagged behind research con4 cerning other diseases, when compared by the num5 ber of individuals affected by, and the relative health 

6 consequences of, the diseases. 

7 (15) The ability of individuals suffering from 

8 eating disorders, particularly bulimia nervosa, binge 

9 eating disorder, and EDNOS to access appropriate 

10 treatment is unacceptably low. 

11 (16) The development of an eating disorder is 

12 frequently preceded by unhealthy weight control be13 haviors commonly identified as disordered eating, in14 cluding skipping meals, using diet pills, taking lax15 atives, self-induced vomiting, and fasting. Such dis16 ordered eating behaviors should be included in en17 hanced research prevention and training efforts. 

18 SEC. 3. PURPOSES. 

19 The purposes of this Act are— 

20 (1) to expand research into the prevention of 

21 eating disorders; 

22 (2) to expand research on effective treatment 

23 and intervention of eating disorders and to support 

24 evidence-based programs designed to prevent eating 

25 disorders; 


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1 (3) to expand research on the causes, courses, 

2 and outcomes of eating disorders; 

3 (4) to increase the number of people properly 

4 screened and diagnosed with an eating disorder; 

5 (5) to improve training and education of health 

6 care and behavioral care providers and of school per7 sonnel at all levels of elementary and secondary edu8 cation; 

9 (6) to improve surveillance and data systems 

10 for tracking the prevalence, severity, and economic 

11 costs of eating disorders; and 

12 (7) to enhance access to comprehensive treat13 ment for eating disorders. 

14 TITLE I—EATING DISORDER 

15 DETECTION AND RESEARCH 

16 SEC. 101. EXPANSION AND COORDINATION OF THE ACTIVI17 TIES OF THE NATIONAL INSTITUTE OF 

18 HEALTH AND THE NATIONAL INSTITUTE OF 

19 MENTAL HEALTH WITH RESPECT TO RE20 SEARCH ON EATING DISORDERS. 

21 Part B of title IV of the Public Health Service Act 

22 (42 U.S.C. 284 et seq.) is amended by adding at the end 

23 the following: 


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1 ‘‘SEC. 409K. EXPANSION AND COORDINATION OF ACTIVI2 TIES WITH RESPECT TO RESEARCH ON EAT3 ING DISORDERS. 

4 ‘‘(a) IN GENERAL.—The Director of NIH, pursuant 

5 to the general authority of such director, shall expand, in6 tensify, and coordinate the activities of the National Insti7 tutes of Health with respect to research on eating dis8 orders. 

9 ‘‘(b) GRANTS.—The Director of NIH may award 

10 grants to public or private entities to pay all or part of 

11 the cost of planning, establishing, improving, and pro12 viding basic operating support for such entities to estab13 lish consortia in eating disorder research and to carry out 

14 the activities described in subsection (e). 

15 ‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive 

16 a grant under this section, an entity shall— 

17 ‘‘(1) be public or nonprofit private entity (in18 cluding a health department of a State, a political 

19 subdivision of a State, or an institution of higher 

20 education); and 

21 ‘‘(2) submit to the Secretary an application at 

22 such time, in such manner, and containing such in23 formation as the Secretary may require. 

24 ‘‘(d) REQUIREMENTS OF CONSORTIA.— 

25 ‘‘(1) IN GENERAL.—Each consortium estab26 lished as described in subsection (b) may use the faVerDate Mar 15 2010 22:25 Mar 04, 2011 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S481.IS S481

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1 cilities of a single lead institution, or may be formed 

2 from several cooperating institutions, meeting such 

3 requirements as may be prescribed by the Director 

4 of NIH. 

5 ‘‘(2) COORDINATION OF CONSORTIA.—The Di6 rector of NIH— 

7 ‘‘(A) may, as appropriate, provide for the 

8 coordination of information among consortia es9 tablished under subsection (b); and 

10 ‘‘(B) shall ensure regular communication 

11 between members of the various consortia es12 tablished using grants awarded under this sec13 tion. 

14 ‘‘(3) REPORTS.—The Director of NIH shall re15 quire each consortium to prepare and submit to such 

16 director annual reports on the activities of such con17 sortium. 

18 ‘‘(e) ACTIVITIES.—Each consortium receiving a grant 

19 under subsection (b) shall conduct basic, clinical, epide20 miological, population-based, or translational research re21 garding eating disorders, which may include research re22 lated to— 

23 ‘‘(1) the identification and classification of eat24 ing disorders and disordered eating; 


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1 ‘‘(2) the causes, diagnosis, and early detection 

2 of eating disorders; 

3 ‘‘(3) the treatment of eating disorders, includ4 ing the development and evaluation of new treat5 ments and best practices; 

6 ‘‘(4) the conditions or diseases related to, or 

7 arising from, an eating disorder; and 

8 ‘‘(5) the evaluation of existing prevention pro9 grams and the development of reliable prevention 

10 and screening programs. 

11 ‘‘(f) COLLABORATION.—The Secretary, acting 

12 through the Director of NIH and the Director of the Na13 tional Institute of Mental Health, shall identify relevant 

14 Federal agencies (including the other institutes and cen15 ters of the National Institutes of Health, the Centers for 

16 Medicare & Medicaid Services, the Centers for Disease 

17 Control and Prevention, the Agency for Healthcare Re18 search and Quality, the Substance Abuse and Mental 

19 Health Services Administration, the Health Resources and 

20 Services Administration, and the Office on Women’s 

21 Health) that shall collaborate with respect to activities 

22 conducted under subsection (d). 

23 ‘‘(g) PUBLIC INPUT.—The Director of NIH shall pro24 vide for a mechanism— 


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1 ‘‘(1) to educate and disseminate information on 

2 the existing and planned programs and research ac3 tivities of the National Institutes of Health with re4 spect to eating disorders; and 

5 ‘‘(2) through which the Director of NIH may 

6 receive comments from the public regarding such 

7 programs and activities. 

8 ‘‘(h) DISSEMINATION OF INFORMATION.—The Direc9 tor of NIH shall provide for a mechanism for making the 

10 results and information generated by the consortia pub11 licly available, such as through the Internet. 

12 ‘‘(i) DEFINITION.—For purposes of this section, the 

13 term ‘eating disorder’ has the meaning given such term 

14 in section 399OO(e). 

15 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—To 

16 carry out this section, there are authorized to be appro17 priated such sums as may be necessary for each of fiscal 

18 years 2012 through 2016.’’. 

19 SEC. 102. INTERAGENCY COORDINATING COUNCIL; SUR20 VEILLANCE AND RESEARCH PROGRAM; 

21 STUDY ON ECONOMIC COST. 

22 Title III of the Public Health Service Act (42 U.S.C. 

23 241 et seq.) is amended by adding at the end the fol24 lowing: 


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1 ‘‘PART W—PROGRAMS RELATING TO EATING 

2 DISORDERS 

3 ‘‘SEC. 399OO. INTERAGENCY EATING DISORDERS COORDI4 NATING COUNCIL. 

5 ‘‘(a) ESTABLISHMENT.—There is established within 

6 the Department of Health and Human Services the Inter7 agency Eating Disorders Coordinating Council (referred 

8 to in this section as the ‘Coordinating Council’). 

9 ‘‘(b) RESPONSIBILITIES.—The Coordinating Council 

10 shall— 

11 ‘‘(1) develop and annually update a summary of 

12 advances in eating disorder research concerning 

13 causes of, prevention of, early screening for, treat14 ment and access to services related to, and supports 

15 for individuals affected by, eating disorders; 

16 ‘‘(2) monitor Federal activities with respect to 

17 eating disorders; 

18 ‘‘(3) make recommendations to the Secretary 

19 regarding any appropriate changes to such activities, 

20 and to the Director of NIH, with respect to the stra21 tegic plan developed under paragraph (4); 

22 ‘‘(4) develop and annually update a strategic 

23 plan for the conduct of, and support for, eating dis24 order research, including proposed budgetary rec25 ommendations; and 


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1 ‘‘(5) submit annually to the Committee on 

2 Health, Education, Labor, and Pensions of the Sen3 ate and the Committee on Energy and Commerce of 

4 the House of Representatives the strategic plan de5 veloped under paragraph (4) and all updates to such 

6 plan. 

7 ‘‘(c) MEMBERSHIP.— 

8 ‘‘(1) CHAIRPERSON.—The Director of NIH 

9 shall serve as the chairperson of the Coordinating 

10 Council and shall be responsible for the leadership 

11 and oversight of the activities of the Coordinating 

12 Council. 

13 ‘‘(2) MEMBERS IN GENERAL.—The Coordi14 nating Council shall be composed of— 

15 ‘‘(A) representatives of— 

16 ‘‘(i) the Agency for Healthcare Re17 search and Quality; 

18 ‘‘(ii) the Substance Abuse and Mental 

19 Health Administration; 

20 ‘‘(iii) the research institutes at the 

21 National Institutes of Health, as the Di22 rector of NIH determines appropriate; 

23 ‘‘(iv) the Health Resources and Serv24 ices Administration; 


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1 ‘‘(v) the Centers for Medicare & Med2 icaid Services; 

3 ‘‘(vi) the Office on Women’s Health; 

4 ‘‘(vii) the Centers for Disease Control 

5 and Prevention; 

6 ‘‘(viii) the Department of Education; 

7 and 

8 ‘‘(ix) any other Federal agency that 

9 the chairperson determines is appropriate; 

10 and 

11 ‘‘(B) the additional members appointed 

12 under paragraph (3). 

13 ‘‘(3) ADDITIONAL MEMBERS.—Not fewer than 

1 14 ⁄3 of the total membership of the Coordinating 

15 Council shall be composed of non-Federal public 

16 members to be appointed by the Secretary, including 

17 representatives of— 

18 ‘‘(A) academic medical centers or schools 

19 of medicine, nursing, or other health profes20 sions; 

21 ‘‘(B) health care professionals who are ac22 tively involved in the treatment of eating dis23 orders; 

24 ‘‘(C) researchers with expertise in eating 

25 disorders; and 


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1 ‘‘(D) at least 2 individuals with a past or 

2 present diagnosis of an eating disorder or par3 ents of individuals with a past or present diag4 nosis of an eating disorder. 

5 ‘‘(d) ADMINISTRATIVE SUPPORT; TERMS OF SERV6 ICE; OTHER PROVISIONS.— 

7 ‘‘(1) ADMINISTRATIVE SUPPORT.—The Coordi8 nating Council shall receive necessary and appro9 priate administrative support from the Secretary. 

10 ‘‘(2) TERMS OF SERVICE.—Members of the Co11 ordinating Council appointed under subsection (c)(2) 

12 shall serve for a term of 4 years, and may be re13 appointed for one or more additional 4-year terms. 

14 Any member appointed to fill a vacancy for an unex15 pired term shall be appointed for the remainder of 

16 such term. A member may serve after the expiration 

17 of the member’s term until a successor has taken of18 fice. 

19 ‘‘(3) MEETINGS.— 

20 ‘‘(A) IN GENERAL.—The Coordinating 

21 Council shall meet at the call of the chairperson 

22 or upon the request of the Secretary. The Co23 ordinating Council shall meet not fewer than 2 

24 times each year. 


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1 ‘‘(B) NOTICE.—Notice of any upcoming 

2 meeting of the Coordinating Council shall be 

3 published in the Federal Register. 

4 ‘‘(C) PUBLIC ACCESS.—Each meeting of 

5 the Coordinating Council shall be open to the 

6 public and shall include appropriate periods of 

7 time for questions by the public. 

8 ‘‘(4) SUBCOMMITTEES.—In carrying out its 

9 functions the Coordinating Council may establish 

10 subcommittees and convene workshops and con11 ferences. 

12 ‘‘(e) EATING DISORDER.—In this part, the term ‘eat13 ing disorder’ includes anorexia nervosa, bulimia nervosa, 

14 binge eating disorder, and eating disorders not otherwise 

15 specified, as defined in the fourth edition of the Diagnostic 

16 and Statistical Manual of Mental Disorders or any subse17 quent edition. 

18 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To 

19 carry out this section, there are authorized to be appro20 priated such sums as may be necessary for each of fiscal 

21 years 2012 through 2016. 

22 ‘‘SEC. 399OO–1. EATING DISORDER SURVEILLANCE AND RE23 SEARCH PROGRAM. 

24 ‘‘(a) IN GENERAL.—The Secretary, acting through 

25 the Director of the Centers for Disease Control and PreVerDate Mar 15 2010 22:25 Mar 04, 2011 Jkt 099200 PO 00000 Frm 00014 Fmt 6652 Sfmt 6201 E:\BILLS\S481.IS S481

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1 vention, shall award grants or cooperative agreements to 

2 eligible entities for the purpose of improving the collection, 

3 analysis and reporting of State epidemiological data on 

4 eating disorders. 

5 ‘‘(b) ACTIVITIES.—An eligible entity shall assist with 

6 the development and coordination of eating disorder sur7 veillance efforts within a region and may— 

8 ‘‘(1) provide for the collection, analysis, and re9 porting of epidemiological data on eating disorders 

10 through the existing surveillance programs; 

11 ‘‘(2) develop recommendations to enhance exist12 ing surveillance programs to more accurately collect 

13 epidemiological data on disordered eating and eating 

14 disorders, including the prevalence, incidence, 

15 trends, correlates, mortality, and causes of eating 

16 disorders and the effects of eating disorders on qual17 ity of life; 

18 ‘‘(3) develop recommendations to improve re19 quirements for ensuring that eating disorders are ac20 curately recorded as underlying and contributing 

21 causes of death; and 

22 ‘‘(4) assist with the development and coordina23 tion of surveillance efforts within a region. 

24 ‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive 

25 an award under this section, an entity shall— 


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1 ‘‘(1) be a public or nonprofit private entity (in2 cluding a health department of a State, a political 

3 subdivision of a State, or an institution of higher 

4 education); and 

5 ‘‘(2) submit to the Secretary an application at 

6 such time, in such manner, and containing such in7 formation as the Secretary may require. 

8 ‘‘(d) TECHNICAL ASSISTANCE.—In making awards 

9 under this section, the Secretary may provide direct tech10 nical assistance in lieu of cash. 

11 ‘‘(e) REPORTS.—Each entity awarded a grant or co12 operative agreement under this section shall annually sub13 mit to the Secretary a report describing the activities con14 ducted using grant funds and providing recommendations 

15 for improving the collection, analysis, and reporting of epi16 demiological data on eating disorders. 

17 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To 

18 carry out this section, there are authorized to be appro19 priated such sums as may be necessary for each of fiscal 

20 years 2012 through 2016. 

21 ‘‘SEC. 399OO–2. STUDY REGARDING ECONOMIC COSTS OF 

22 EATING DISORDERS. 

23 ‘‘Not later than 18 months after the date of enact24 ment of the Federal Response to Eliminate Eating Dis25 orders Act, the Secretary, acting through the Director of 


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1 the Centers for Disease Control and Prevention, shall con2 duct a study evaluating the economic costs of eating dis3 orders. Such study may examine years of productive life 

4 lost, missed days of work, reduced work productivity, costs 

5 of medical and mental health treatment, costs to family, 

6 and costs to society as a result of eating disorders.’’. 

7 TITLE II—EATING DISORDER 

8 EDUCATION AND PREVEN9 TION; STUDIES ON EATING 

10 DISORDERS AND BODY MASS 

11 INDEX; PUBLIC SERVICE AN12 NOUNCEMENTS 

13 SEC. 201. GRANTS TO PREVENT EATING DISORDERS. 

14 Title III of the Public Health Service Act (42 U.S.C. 

15 241 et seq.), as amended by section 102, is further amend16 ed by adding at the end the following: 

17 ‘‘SEC. 399OO–3. GRANTS TO PREVENT EATING DISORDERS. 

18 ‘‘(a) IN GENERAL.—The Secretary, acting through 

19 the Director of the Centers for Disease Control and Pre20 vention and in coordination with the Administrator of the 

21 Health Resources and Services Administration, shall 

22 award grants to eligible entities to plan, implement, and 

23 evaluate programs to prevent eating disorders and obesity 

24 and the acute and chronic medical conditions that accomVerDate Mar 15 2010 22:25 Mar 04, 2011 Jkt 099200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\S481.IS S481

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1 pany such conditions, and to promote healthy body image 

2 and appropriate nutrition-based eating behaviors. 

3 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 

4 under this section, an entity shall— 

5 ‘‘(1) be a State, local or tribal educational 

6 agency, an accredited institution of higher education, 

7 a State or local health department, or a community8 based organization; and 

9 ‘‘(2) submit an application to the Secretary at 

10 such time, in such manner, and containing such in11 formation as the Secretary may require. 

12 ‘‘(c) USE OF FUNDS.—An entity receiving a grant 

13 under this section shall fund development and testing of 

14 school-, clinic-, community-, or health department-based 

15 programs designed to promote healthy eating behaviors 

16 and to prevent eating disorders including— 

17 ‘‘(1) developing evidence-based interventions to 

18 prevent eating disorders, including educational or 

19 intervention programs regarding nutritional content, 

20 understanding and responding to hunger and sati21 ety, positive body image development, positive self22 esteem development, and life skills, that take into 

23 account cultural and developmental issues and the 

24 role of family, school, and community; 


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1 ‘‘(2) planning and implementing a healthy life2 style curriculum or program with an emphasis on 

3 healthy eating behaviors, physical activity, and emo4 tional wellness, the connection between emotional 

5 and physical health, and the prevention of bullying 

6 based on body size, shape, and weight; 

7 ‘‘(3) forming partnerships with parents and 

8 caregivers to educate adults about identifying 

9 unhealthy eating behaviors and promoting healthy 

10 eating behaviors, physical activity, and emotional 

11 wellness; and 

12 ‘‘(4) integrating eating disorder prevention and 

13 awareness in physical education, health, education, 

14 athletic training programs, and after-school rec15 reational sports programs, to the extent possible. 

16 ‘‘(d) REQUIREMENTS OF GRANT RECIPIENTS.— 

17 ‘‘(1) LIMITATION ON ADMINISTRATIVE EX18 PENSES.—A recipient of a grant under this section 

19 shall not use more than 10 percent of the amounts 

20 received under a grant under this section for admin21 istrative expenses. 

22 ‘‘(2) CONTRIBUTION OF FUNDS.—A recipient of 

23 a grant under this section, and any entity receiving 

24 assistance under the grant for training and edu25 cation, shall contribute non-Federal funds, either diVerDate Mar 15 2010 22:25 Mar 04, 2011 Jkt 099200 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 E:\BILLS\S481.IS S481

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1 rectly or through in-kind contributions, to the costs 

2 of the activities to be funded under the grant in an 

3 amount that is not less than 10 percent of the total 

4 cost of such activities. 

5 ‘‘(3) EVALUATION.—Each recipient of a grant 

6 under this section shall provide to the Secretary, in 

7 such form and manner as the Secretary shall speci8 fy, relevant data and an evaluation of the activities 

9 of the grant recipient in promoting healthy eating 

10 behaviors and preventing eating disorders. Evalua11 tion reports shall be made publicly available, such as 

12 through the Internet. 

13 ‘‘(e) TECHNICAL ASSISTANCE.—The Secretary may 

14 set aside an amount not to exceed 1 percent of the total 

15 amount appropriated for a fiscal year to provide grantees 

16 with technical support in the development, implementa17 tion, and evaluation of programs under this section and 

18 to disseminate information about preventing and treating 

19 eating disorders and obesity. 

20 ‘‘SEC. 399OO–4. STUDY OF EATING DISORDERS IN ELEMEN21 TARY SCHOOLS, SECONDARY SCHOOLS, AND 

22 INSTITUTIONS OF HIGHER EDUCATION. 

23 ‘‘Not later than 18 months after the date of enact24 ment of the Federal Response to Eliminate Eating Dis25 orders Act, the National Center for Health Statistics of 


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1 the Centers for Disease Control and Prevention and the 

2 National Center for Education Statistics of the Depart3 ment of Education shall conduct a joint study, or enter 

4 into a contract to have a study conducted, on the impact 

5 eating disorders have on educational advancement and 

6 achievement. The study shall— 

7 ‘‘(1) determine the incidence of eating disorders 

8 and disordered eating among students, and the mor9 bidity and mortality rates associated with eating dis10 orders; 

11 ‘‘(2) evaluate the extent to which students with 

12 eating disorders are more likely to miss school, have 

13 delayed rates of development, or have reduced cog14 nitive skills; 

15 ‘‘(3) report on current State and local programs 

16 to increase awareness about the dangers of eating 

17 disorders among youth and to prevent eating dis18 orders and the risk factors for eating disorders, and 

19 evaluate the value of such programs; and 

20 ‘‘(4) make recommendations on measures that 

21 could be undertaken by Congress, the Department of 

22 Education, States, and local educational agencies to 

23 strengthen eating disorder prevention and awareness 

24 programs including development of best practices. 


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1 ‘‘SEC. 399OO–5. STUDY OF THE SUITABILITY OF MANDATING 

2 BODY MASS INDEX REPORTING IN ELEMEN3 TARY SCHOOLS AND SECONDARY SCHOOLS. 

4 ‘‘Not later than 18 months after the date of enact5 ment of the Federal Response to Eliminate Eating Dis6 orders Act, the Director of the Centers for Disease Control 

7 and Prevention, in consultation with the Secretary of Edu8 cation, shall conduct a study on mandatory reporting of 

9 body mass index, including— 

10 ‘‘(1) how many schools are currently conducting 

11 mandatory reporting of body mass index; 

12 ‘‘(2) how schools are assessing the impacts of 

13 such mandatory reporting on body mass index; and 

14 ‘‘(3) how schools are assessing potential unin15 tended consequences of such mandatory reporting on 

16 students, including those related to parent and peer 

17 relations. 

18 ‘‘SEC. 399OO–6. PUBLIC SERVICE ADVERTISEMENTS. 

19 ‘‘The Secretary, in consultation with the Director of 

20 the National Institutes of Health and the Secretary of 

21 Education, shall carry out a program to develop, dis22 tribute, and promote the broadcasting of public service an23 nouncements to improve public awareness of, and to pro24 mote the identification and prevention, of eating disorders. 


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1 ‘‘SEC. 399OO–7. AUTHORIZATION OF APPROPRIATIONS. 

2 ‘‘To carry out sections 399OO–3, 399OO–4, 399OO– 

3 5, and 399OO–6, there are authorized to be appropriated 

4 such sums as may be necessary for each of fiscal years 

5 2012 through 2016.’’. 

6 SEC. 202. SENSE OF THE SENATE. 

7 It is the sense of the Senate that critically necessary 

8 programs to reduce obesity in children may also uninten9 tionally increase the unhealthy weight control behaviors 

10 that can lead to development of eating disorders, and that 

11 federally funded programs to combat obesity should take 

12 this connection into consideration. 

13 TITLE III—IMPROVING TRAIN14 ING IN HEALTH PROFES15 SIONS, EDUCATION, AND RE16 LATED FIELDS 

17 SEC. 301. GRANTS FOR HEALTH PROFESSIONALS. 

18 Part D of title VII of the Public Health Service Act 

19 (42 U.S.C. 294 et seq.) is amended by adding at the end 

20 the following: 

21 ‘‘SEC. 760. GRANTS FOR HEALTH PROFESSIONALS. 

22 ‘‘(a) GRANTS.—The Secretary, acting through the 

23 Administrator of the Health Resources and Services Ad24 ministration, in collaboration with the Director of the Cen25 ters for Disease Control and Prevention, shall award 

26 grants under this section to develop interdisciplinary 


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1 training and education programs that provide under2 graduate, graduate, post-graduate medical, nursing (in3 cluding advanced practice nursing students), dental, men4 tal and behavioral health, pharmacy, and other health pro5 fessions students or residents with an understanding of, 

6 and clinical skills pertinent to identifying and treating, 

7 eating disorders. 

8 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 

9 under this section an entity shall— 

10 ‘‘(1) be an accredited school of allopathic or os11 teopathic medicine, or an accredited school of nurs12 ing, public health, social work, dentistry, behavioral 

13 and mental health, or pharmacy, or an accredited 

14 medical, dental, or nursing residency program; 

15 ‘‘(2) prepare and submit to the Secretary an 

16 application at such time, in such manner, and con17 taining such information as the Secretary may re18 quire. 

19 ‘‘(c) USE OF FUNDS.— 

20 ‘‘(1) REQUIRED USES.—Amounts provided 

21 under a grant awarded under this section shall be 

22 used to fund interdisciplinary training and education 

23 projects that are designed to train medical, nursing, 

24 and other health professions students and residents 

25 to— 


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1 ‘‘(A) better identify patients at-risk of be2 coming overweight or obese or developing an 

3 eating disorder; 

4 ‘‘(B) detect overweight or obesity or eating 

5 disorders among a diverse patient population; 

6 ‘‘(C) counsel, refer, or treat patients with 

7 overweight or obesity or an eating disorder; 

8 ‘‘(D) educate patients and the families of 

9 patients about effective strategies to establish 

10 healthy eating habits and appropriate levels of 

11 physical activity; and 

12 ‘‘(E) assist in the creation and administra13 tion of community-based overweight and obesity 

14 and eating disorder prevention efforts. 

15 ‘‘(2) PERMISSIVE USE.—Amounts provided 

16 under a grant under this section may be used to 

17 offer community-based training opportunities in 

18 rural areas for medical, nursing, and other health 

19 professions students and residents on eating dis20 orders, which may include the use of distance learn21 ing networks and other available technologies needed 

22 to reach isolated rural areas. 

23 ‘‘(d) REQUIREMENTS OF GRANTEES.— 

24 ‘‘(1) LIMITATION ON ADMINISTRATIVE EX25 PENSES.—A grantee shall not use more than 10 perVerDate Mar 15 2010 22:25 Mar 04, 2011 Jkt 099200 PO 00000 Frm 00025 Fmt 6652 Sfmt 6201 E:\BILLS\S481.IS S481

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1 cent of the amounts received under a grant under 

2 this section for administrative expenses. 

3 ‘‘(2) CONTRIBUTION OF FUNDS.—A grantee 

4 under this section, and any entity receiving assist5 ance under the grant for training and education, 

6 shall contribute non-Federal funds, either directly or 

7 through in-kind contributions, to the costs of the ac8 tivities to be funded under the grant in an amount 

9 that is not less than 10 percent of the total cost of 

10 such activities. 

11 ‘‘(e) EATING DISORDER.—In this section, the term 

12 ‘eating disorder’ has the meaning given such term in sec13 tion 399OO(e). 

14 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

15 are authorized to be appropriated to carry out this section 

16 such sums as may be necessary for fiscal years 2012 

17 through 2016.’’. 

18 SEC. 302. TRAINING IN ELEMENTARY AND SECONDARY 

19 SCHOOLS. 

20 Section 5131(a) of the Elementary and Secondary 

21 Education Act of 1965 (20 U.S.C. 7215(a)) is amended 

22 by adding at the end the following: 

23 ‘‘(28) Programs to improve the identification of 

24 students with eating disorders (as defined in section 

25 399OO of the Public Health Service Act), increase 


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1 awareness of such disorders among parents and stu2 dents, and train educators (including teachers, 

3 school nurses, school social workers, coaches, school 

4 counselors, and administrators) on effective eating 

5 disorder prevention, screening, detection and assist6 ance methods.’’. 

7 TITLE IV—IMPROVING AVAIL8 ABILITY AND ACCESS TO 

9 TREATMENT 

10 SEC. 401. MEDICAID COVERAGE FOR EATING DISORDER 

11 TREATMENT SERVICES. 

12 (a) IN GENERAL.—Section 1905 of the Social Secu13 rity Act (42 U.S.C. 1396d(a)) is amended— 

14 (1) in subsection (a)— 

15 (A) in paragraph (28), by striking ‘‘and’’ 

16 at the end; 

17 (B) by redesignating paragraph (29) as 

18 paragraph (30); and 

19 (C) by inserting after paragraph (28) the 

20 following new paragraph: 

21 ‘‘(29) eating disorder treatment services (as de22 fined in subsection (ee)(1)); and’’; and 

23 (2) by adding at the end the following new sub24 section: 

25 ‘‘(ee) EATING DISORDER TREATMENT SERVICES.— 


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1 ‘‘(1) DEFINITION.—The term ‘eating disorder 

2 treatment services’ means services relating to diag3 nosis and treatment of an eating disorder (as de4 fined in section 399OO of the Public Health Service 

5 Act), including screening, counseling, pharmacother6 apy (including coverage of drugs described in para7 graph (2)), and other necessary health care services. 

8 ‘‘(2) COVERAGE FOR PHARMACOLOGICAL

9 TREATMENT OF EATING DISORDERS.—For purposes 

10 of paragraph (1), eating disorder treatment services 

11 shall include drugs provided as part of care in an in12 patient setting, covered outpatient drugs (as defined 

13 in section 1927(k)(2)), and non-prescription drugs 

14 described in section 1927(d)(2)(A) that are pre15 scribed, in accordance with generally accepted med16 ical guidelines, for treatment of an eating disorder.’’. 

17 (b) INCREASED FMAP FOR EATING DISORDER

18 TREATMENT SERVICES.— 

19 (1) EFFECTIVE UNTIL JANUARY 1, 2013.—Sec20 tion 1905(b) of the Social Security Act (42 U.S.C. 

21 1396d(b)) is amended in the first sentence— 

22 (A) by striking ‘‘and’’ before ‘‘(4)’’; and 

23 (B) by inserting before the period at the 

24 end the following: ‘‘, and (5) the Federal med25 ical assistance percentage shall be equal to the 


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1 enhanced FMAP described in section 2105(b) 

2 with respect to medical assistance for eating 

3 disorder treatment services (as defined in sub4 section (ee)(1)) provided to an individual who is 

5 eligible for such assistance and has an eating 

6 disorder (as defined in section 399OO of the 

7 Public Health Service Act)’’. 

8 (2) EFFECTIVE JANUARY 1, 2013.—Section 

9 4106(b) of the Patient Protection and Affordable 

10 Care Act (Public Law 111–148) is amended— 

11 (A) in paragraph (1), by striking ‘‘(4)’’ 

12 each time such term appears and inserting 

13 ‘‘(5)’’; and 

14 (B) in paragraph (2), by striking ‘‘, and 

15 (5)’’ and inserting ‘‘, and (6)’’. 

16 (c) INCLUSION IN EPSDT SERVICES.—Section 

17 1905(r)(1)(B) of such Act (42 U.S.C. 1396d(r)(1)(B)) is 

18 amended— 

19 (1) in clause (iv), by striking ‘‘and’’ at the end; 

20 (2) in clause (v), by striking the period at the 

21 end and inserting ‘‘; and’’; and 

22 (3) by inserting after clause (v) the following 

23 new clause: 

24 ‘‘(vi) appropriate diagnostic services 

25 relating to eating disorders (as defined in 


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1 section 399OO of the Public Health Serv2 ice Act).’’. 

3 (d) EXCEPTION FROM OPTIONAL RESTRICTION

4 UNDER MEDICAID DRUG COVERAGE.—Section 

5 1927(d)(2)(A) of such Act (42 U.S.C. 1396r–8(d)(2)(A)) 

6 is amended by inserting before the period at the end the 

7 following: ‘‘, except for drugs that are prescribed, in ac8 cordance with generally accepted medical guidelines, for 

9 the purpose of treatment of an individual who is eligible 

10 for medical assistance under the State plan and has an 

11 eating disorder (as defined in section 399OO of the Public 

12 Health Service Act)’’. 

13 (e) EFFECTIVE DATE.—The amendments made by 

14 this section shall apply to drugs and services furnished 

15 on or after January 1, 2012. 

16 SEC. 402. GRANTS TO SUPPORT PATIENT ADVOCACY. 

17 Subpart II of part D of title IX of the Public Health 

18 Service Act is amended by adding at the end the following: 

19 ‘‘SEC. 938. GRANTS TO SUPPORT PATIENT ADVOCACY. 

20 ‘‘(a) GRANTS.—The Secretary, acting through the 

21 Director, shall award grants under this section to develop 

22 and support patient advocacy work to help individuals with 

23 eating disorders obtain adequate health care services and 

24 insurance coverage. 


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1 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 

2 under this section, an entity shall— 

3 ‘‘(1) be a public or nonprofit private entity (in4 cluding a health department of a State or tribal 

5 agency, a community-based organization, or an insti6 tution of higher education); 

7 ‘‘(2) prepare and submit to the Secretary an 

8 application at such time, in such manner, and con9 taining such information as the Secretary may re10 quire, including— 

11 ‘‘(A) comprehensive strategies for advo12 cating on behalf of, and working with, individ13 uals with eating disorders or at risk for devel14 oping eating disorders; 

15 ‘‘(B) a plan for consulting with commu16 nity-based coalitions, treatment centers, or eat17 ing disorder research experts who have experi18 ence and expertise in issues related to eating 

19 disorders or patient advocacy in providing serv20 ices under a grant awarded under this section; 

21 and 

22 ‘‘(C) a plan for financial sustainability in23 volving State, local, and private contributions. 


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1 ‘‘(c) USE OF FUNDS.—Amounts provided under a 

2 grant awarded under this section shall be used to support 

3 patient advocacy work, including— 

4 ‘‘(1) providing education and outreach in com5 munity settings regarding eating disorders and asso6 ciated health problems, especially among low-income, 

7 minority, and medically underserved populations; 

8 ‘‘(2) facilitating access to appropriate, ade9 quate, and timely health care for individuals with 

10 eating disorders and associated health problems; 

11 ‘‘(3) assisting in communication and coopera12 tion between patients and providers; 

13 ‘‘(4) representing the interests of patients in 

14 managing health insurance claims and plans; 

15 ‘‘(5) providing education and outreach regard16 ing enrollment in health insurance, including enroll17 ment in the Medicare program under title XVIII of 

18 the Social Security Act, the Medicaid program under 

19 title XIX of such Act, and the Children’s Health In20 surance Program under title XXI of such Act; 

21 ‘‘(6) identifying, referring, and enrolling under22 served populations in appropriate health care agen23 cies and community-based programs and organiza24 tions in order to increase access to high-quality 

25 health care services; 


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1 ‘‘(7) providing technical assistance, training, 

2 and organizational support for patient advocates; 

3 and 

4 ‘‘(8) creating, operating, and participating in 

5 State or regional networks of patient advocates. 

6 ‘‘(d) REQUIREMENTS OF GRANTEES.— 

7 ‘‘(1) LIMITATION ON ADMINISTRATIVE EX8 PENSES.—A grantee shall not use more than 5 per9 cent of the amounts received under a grant under 

10 this section for administrative expenses. 

11 ‘‘(2) CONTRIBUTION OF FUNDS.—A grantee 

12 under this section, and any entity receiving assist13 ance under the grant for training and education, 

14 shall contribute non-Federal funds, either directly or 

15 through in-kind contributions, to the costs of the ac16 tivities to be funded under the grant in an amount 

17 that is not less than 75 percent of the total cost of 

18 such activities. 

19 ‘‘(3) REPORTING TO SECRETARY.—A grantee 

20 under this section shall annually submit to the Sec21 retary a report, at such time, in such manner, and 

22 containing such information as the Secretary may 

23 require, including a description and evaluation of the 

24 activities described in subsection (c) carried out by 

25 such entity. 


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1 ‘‘(e) EATING DISORDER.—In this section, the term 

2 ‘eating disorder’ has the meaning given such term in sec3 tion 399OO(e). 

4 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To 

5 carry out this section, there are authorized to be appro6 priated such sums as may be necessary for fiscal years 

7 2012 through 2016.’’. 

Æ 


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